, Volume 23, Issue 2, pp 88-100

A computerized social cognitive intervention for nutrition behavior: Direct and mediated effects on fat, fiber, fruits, and vegetables, self-efficacy, and outcome expectations among food shoppers

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Abstract

This study examined the direct and mediated impact of a self-administered, computer-based intervention on nutrition behavior, self-efficacy, and outcome expectations among supermarket food shoppers. The intervention, housed in kiosks in supermarkets and based on social cognitive theory, used tailored information and self-regulation strategies delivered in 15 brief weekly segments. The study sample (N = 277), stratified and randomly assigned to treatment or control, was 96% female, was 92% White, had a median annual income of about $35,000, and had a mean education of 14.78 ±2.11 years. About 12% of the sample reported incomes of $20,000 or less, and about 20% reported 12 years or fewer of education. Analysis of covariance immediately after intervention and at a 4- to 6-month follow-up found that treatment led to improved levels of fat, fiber, and fruits and vegetables. Treatment also led to higher levels of nutrition-related self-efficacy, physical outcome expectations, and social outcome expectations. Logistic regression analysis determined that the treatment group was more likely than the control group to attain goals for fat, fiber, and fruits and vegetables at posttest and to attain goals for fat at follow-up. Latent variable structural equation analysis revealed self-efficacy and physical outcome expectations mediated treatment effects on nutrition. In addition, physical outcome expectations mediated the effect of self-efficacy on nutrition outcomes. Implications for future computer-based health promotion interventions are discussed.

This study was funded by The National Cancer Institute Grant 2RO1CA45926-06A1. The Institutional Review Board of the Virginia Polytechnic Institute and State University approved the study. An earlier version of this article was presented at the 2000 Annual Conference of the Society of Behavioral Medicine, April 5-8, 2000.
We acknowledge the contributions of Janet Walberg-Rankin, Ph.D., in developing NLS content and measurement strategies; Patricia G. Bickley, Ph.D., in developing NLS content and procedures; Jessica Whitely for background research; and Archie Fralin from the Kroger Co., Inc. in assisting the conduct of the project in five stores.We also acknowledge the work of Jennifer Fretz, Jessica Psujek, Felicity Mitton, Brad Harris, and David Wang in database management. These staff members, as well as Susan Allaie, Ann Jones, Oliver Chen, Anup Sharma, Ruby Cockran, Kristi Graves, and Rosell Jeffries, were essential to participant recruitment, data entry, and related tasks. We are also grateful to the store managers and personnel of Kroger supermarkets for their help and support.